Prof. Giorgio Walter CanonicaAllergy and Respiratory Diseases Department

University of Genoa

Cancun, December 7, 2011

Past President 1°vice President

GA2LEN WAO GA2LEN WAO and Guidelinesand Guidelines

Compalati 09

Guyatt GHACP J Club 1991 Mar-Apr

2

20 years20 years

Bousquet J. et al.,Allergy 2004 Bousquet J. et al.,Allergy 2004

ConclusionsQualityGraphicsProceduresPrinciplesBackground

Shekelle BMJ 1999; 318; 593-596 Università degli Studi di Genova

metanalysismetanalysis

Opinion Based Opinion Based

Mildpersistent

ARIA Guidelines: Recommendationsfor Management of Allergic Rhinitis

Mildintermittent

Moderate/severe

intermittent

Moderate/severe

persistent

Consider immunotherapy

Allergen and irritant avoidance

Intranasal decongestant (<10 days) or oral decongestant

Second-generation nonsedating H1-antihistamine

Leukotriene receptor antagonists

Local chromone

Intranasal corticosteroid

Check for asthma

Bousquet et al. J Allergy Clin Immunol. 2001;108(5 suppl):S147. At: http://www.whiar.org.

EAACI/GA2LEN/EDF Guidelines for Management of Urticaria

Zuberbier et al. Allergy. 2006;61:321-331.

EAACI / WAO / GA2LEN / EDF Guidelines

Urticaria 20083rd International Consensus Meeting on Urticaria

Management

Zuberbier et al. Allergy. 2009; 64: 1427-1443.

A general process in guidelines evolutionA general process in guidelines evolution

Factors that influence the strength of a recommendation

• Balance between desirable and undesirable effects

• Quality of evidence

• Patients’ values and preferences

• Costs

Braido et al. Allergy 2010: DOI: 10.1111/j.1398-9995.2010.02383.x.

Baiardini et al 2011

2012

Thank YouThank You

canonica@unige.it canonica@unige.it